ethical considerations around medical assistance in...
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Ethical Considerations Around Medical Assistance in Dying
Gary Lepine, DTh Clinical Ethicist Alberta Health Services Rockyview General Hospital South Health Campus
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The Changing Canadian Landscape
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Carter v. Canada (2015)
Struck down the prohibition against assisted dying for: A competent adult person who clearly consents and who
has a grievous and irremediable medical condition (including an illness, disease or disability) that causes them enduring and intolerable suffering.
Protects care providers’ rights to conscientious objection. Requires health systems to protect members of vulnerable
populations.
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Basically follows the Carter decision. It notably adds the requirement that eligible patients must
be at a point where their death is reasonably foreseeable.
Articulates several procedural safeguards. Explicitly provides legal protection to non-physician health
care providers and others operating within their normal scope of practice.
Bill C-14 (June 17, 2016)
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Definitions !
Assisted Suicide Patient self-administers a lethal dose prescribed by a physician Voluntary Euthanasia Physician prescribes and administers lethal dose to consenting and capable person Patient expresses sustained, well-informed, un-coerced decision to end their life.
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• A growing significance of individual evaluations of quality of life.
• A growing social acceptance of limited instances of intending death as a means of relieving suffering and respecting autonomy.
Two Key Elements
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• Respect for Patient Autonomy. • Benefiting Patients • Fairness • Preciousness of Life • Limits of Human Authority • Protection of Vulnerable
Persons.
The Ethics of Medical Assistance in Dying
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Our Narrative
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• Portraying moral perspectives in terms of arguments “for” and “against” can create the false impression there are only two perspectives to be had on this issue.
• We may also make false assumptions about others’ underlying values and beliefs based on what we know about their perspective on medical assistance in dying.
• In reality, people hold much more diverse and nuanced views.
In Thinking About the Ethics, We Need to Take Care
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Federal government has stated that it will review and research:
• Potential eligibility of mature minors. • Potential eligibility of those whose deaths are not
reasonably foreseeable (including, for example, persons with mental health conditions).
• Potential role for advance directives.
Issues down the road...
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• Respect – treating others kindly and well, whatever their views are.
• Compassion – recognizing the struggle in others. • Humility – acknowledging that we likely do not know the
nuances of each others values and beliefs.
Our Behaviour and Responses to Each Other Should be Guided by:
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Questions